By Dr John Middleton, FPH Vice President
A perfect storm has been brewing over the summer about press invasions of privacy and corrupt police practices. But if the public and politicians are concerned about the threat to their privacy how much more should they be concerned about the threat to their health?
In its response to the public health white paper consultation, The Way Forward, the Department of Health says effectively: “Show us more evidence that regulation of public health professionals is required.” Was the Secretary of State not in the House on Wednesday 13 July? Or lurking in the corridors of power for the select committee interrogation of the Murdochs on 19 July? Has he not heard the pronouncements of the Prime Minister about the regulation of the press? Do these not offer any clues on the need for regulation of public health specialists? The story below is from the Health Service Journal in the autumn of 2016…
“In separate incidents around the country – the UK public health system has failed to stop major outbreaks of tuberculosis, E coli hemolytic uremic syndrome and salmonella. There have been high-profile deaths from the failure to immunize against measles. Major screening disasters have seen deaths of women from preventable cervical and breast cancers. Public concern has been heightened by further allegations that local health and wellbeing board strategies have failed to identify people at highest risk of coronary heart disease and so implement the most effective strategies for preventing death and disability. Public safety was compromised when the Government refused to take action to regulate all public health specialist practice. Local authorities handed public health duties to assistant directors in council services without formal and approved public health qualifications, to agreed national standards.
“The prime minister, under pressure from unprecedented public concern made the following statement yesterday: ‘Not the smallest freedom we cherish in this country is the freedom to be alive. People who were not fit and proper were allowed to undertake vital roles in securing public health safety, in setting priorities for local authorities to determine which life-saving services they should invest in and advise clinical commissioning groups where the best choices to save lives were to be made.
“‘I am determined that this government will take the following actions. One: action will be taken to get to the bottom of the specific revelations and allegations about incompetent management of infectious-disease outbreaks, poor surveillance of major public health problems and inadequate advice to health and wellbeing boards and clinical commissioners to determine where local government and health services should have spent their money. Two: action will be taken to learn wider lessons for the future of the public health profession in this country. And three: that there will be clarity – real clarity – about how all this has come to pass and the responsibilities we all have for the future.
“‘…We need action as well to learn the wider lessons for the future. In particular, we should look at how our public health services are regulated and make recommendations… Of course it is vital that our public health specialists are independent. But public health freedom does not mean that public health should be above the law. Yes, there is much excellent public health practice in Britain today. But I think it’s now clear to everyone that the way public health is regulated is not working. Let’s be honest, voluntary regulation has failed. In these cases it was, frankly, completely absent. Therefore we have to conclude that it is ineffective and lacking in rigour. There is a strong case for saying it is institutionally conflicted. As a result, it lacks public confidence. So I believe we need a new system entirely.
“‘For people watching this scandal unfold, there is something disturbing about what they see. Just think of those in whom they put their trust: the politicians to represent them and Public Health England and local authority public health to inform them and protect them. All of them have let them down.
“‘…I want a regulatory system that is statutory and ensures the safety of the public’s health that has proved itself beyond reproach… a political system that people feel is on their side… and public health practitioners that are, yes, independent and rigorous, that investigate and protect, …that hold those in power to account and occasionally – yes, even regularly – drive them mad, but, in the end, are an independent professional public health service that are also clean and trustworthy. That is what people want. That is what I want. And I will not rest until we get it.’
“The BBC’s political editor asked the question: ‘Prime minister, isn’t that what the Scally report recommended in 2010?'”
The NHS Futures Forum got it. The Government refused to accept its recommendation. The Way Forward document still asks for more evidence that public health needs statutory regulation across all its professionals. Public health is life-saving business. The public deserves to be protected. The professionals deserve protection from themselves. Their employers need protection through assurance of standards and regulation. What’s right for the press is right also for the public’s health.